Wednesday, April 16, 2014

The Intown Midwifery group in Atlantic ended up being the ones who seemed most comfortable with breech babies, and also were willing to accept me as a very late transfer. I didn't investigate providers west of the Mississippi much ;). Several others whose names you turned up were friendly and kind enough to speak with me, but either would not accepted a late transfer or would not accept a complete breech.

So we went down to Atlanta and met with Dr. Bootstaylor, the perinatologist who supports the midwives. He was extremely kind and relaxed. We did try a second cephalic version with him, also to no avail. He explained that in his opinion the studies showing successful vaginal deliveries for complete breech are skewed, and the results are actually worse but people don't report that. However, he was a willing to support me trying, with the understanding that we wanted to see steady progress, and that if she dropped into footling in labor that would mean a c section.

As it turned out, most of this never applied. My water broke early in the morning two days after my due date. We went in immediately, as they were concerned about the potential for cord prolapse. Dr. Bootstaylor came in and did an ultrasound which showed no sign of the cord underneath her. So we tried to get labor going, but it wasn't until after midnight that I really started having contractions. I continued for maybe five hours, and was dilating, but the baby's heart rate was in the 160s and losing variability. Since my water had been broken for more than 24 hours at this point, there was concern for chorioamnionitis, and we decided to go ahead with a c section. I was pretty far out of it by that point, but my husband was doing a great job of asking questions and standing up for me, so I do believe the c section was necessary. Oddly, after all that, the c section wasn't actually for breech, but for complication of prolonged rupture of membranes.

Her Apgars were 3 and 8, and she spent several minutes getting suctioned and stimulated before she was stable enough to be put on my chest. However, she had no respiratory problems after that, so I think that was just the usual "slow to get started" of a breech baby.

She then proceeded to get admitted to NICU because some screening blood work was concerning for neonatal sepsis and she "needed" iv antibiotics. I was really unhappy about not having her with me, but the test showed a high risk of a serious infection, and we didn't want to gamble with that. Somewhere in here, though, the breastfeeding got very messed up. She will barely latch at all, so I'm pumping, supplementing due to low supply, and finger feeding this to her. Plus my incision got infected and is a bit of a mess. So basically all the short term complications of a c section...

However; my little girl is beautiful, and I am working on enjoying her, in between all the chaos. Next time, I am thinking seriously about HBAC. Despite the best efforts and intentions of our providers, my husband and I both feel like we definitely got swept down the slippery slope of interventions, especially as far as our daughter was concerned, and would like to avoid getting started on that road in future. Also, next time, a doula. ;) I definitely overestimated my ability to cope with labor and also deal with medical providers, as well as my husband's ability to intuit what would be helpful to me.

Anyway. Thank you again for your help. Despite how things turned out, I am very glad that I had the option to try, and that we pursued it. As conflicted as I feel about the whole chain of events, I would be even more unhappy if I hadn't tried to avoid the c section.

2 comments:

Good for you, Mama! I'm sorry you've had a rocky toad since birth, but I think you are right that you gave it your all and that is something to be proud of. Congratulations on your sweet baby and I hope you both get better soon! Definitely look into baby probiotics for your little one and I've read that LCs and electric breast pumps are covered by insurance now!